Monday, April 22, 2013

Rejecting Medicaid expansion too risky (with video)

Health care providers
are urging Gov. Scott Walker and lawmakers to reverse course and expand
Medicaid in Wisconsin. / AP Photo/Scott Bauer
There are many unknowns as the health care industry and other private
businesses prepare for the implementation of the health care reform law
known as Obamacare. The U.S. health care system is one of “Byzantine
complexity,” as Dr. Larry Hegland, chief medical officer at Ministry
Saint Clare’s Hospital, told the Daily Herald Media Editorial Board in
an interview last week. Obamacare didn’t create that problem, and it
doesn’t cure it.

One of the key and very
positive provisions in the law is the expansion of Medicaid, the
insurance program for low-income families and individuals, known in
Wisconsin as BadgerCare. The expansion, which would make the program
available to people with incomes up to 138 percent of the federal
poverty level, was rejected by Gov. Scott Walker, who instead unveiled a
system that would push people who fall between 100 percent and 138
percent of poverty into a new, private market for health insurance known
as a health exchange.

Here’s the problem,
according to a broad coalition of hospitals, doctors and other providers
we interviewed: The exchanges might not work. They might be too complex
for this population to navigate without help. They might be overloaded
at first, and there might not be enough customer help to get people what
they need.

We don’t know because
the health insurance exchanges are not up and running yet. That in
itself is a reason not to build a plan, as Walker has, that relies on
Obamacare exchanges running smoothly when the reality seems likely to be
anything but.

Health care leaders are
right. It’s risky. And the fact that essentially the entire health care
field is speaking with one voice on this issue — along with Hegland, we
met with representatives of Aspirus Wausau Hospital, the Wisconsin
Hospital Association and the Wisconsin Medical Society — ought to cause
lawmakers to give this issue a second look as they write the budget for
the coming biennium. There’s a strong argument for delaying the time
when the state begins to push people onto the exchanges.